few noob questions I was unable to found already answered

[arhi]

Hi all, I did a detailed search of the forum but it's so huge that missing stuff and duplicating stuff is inevitable so please don't be mad at me for asking maybe answered questions, especially as I'm new to terminology and English is far from being my first language (pointing me to links to threads with answers is great answer for me ).. anyhow .. some questions I didn't manage to find answer on my own.

1. date/time: when I load data into sleepyhead/encore I see data is properly timed (didn't really check if DST is properly handled but .. night is night, day is day..) but on my machine I do not see, anywhere, not even in the "secret setup" section, a way to edit date/time ?! I'm sure machine has to have a real time clock in order to work, and we all know they can drift from real time so having accurate time there is IMO required... anyone with idea how to read/set datetime on the PR machine? I'm expecting my oxymeter to arrive soon and I'm building one myself in the meantime, so pairing the two graphs would be meaningless if the two device do not have same datetime.

2. hygiene/humidifier, I read number of posts about "if you wanna clean your gear 2 times a day go do it, if you don't wanna clean it ever, don't..." with "no proven serious sickness induced by the cpap being dirty" ... anyhow, I'm interested in another thing.. I have humidifier attached to the cpap, it's summer now and humidity is very high so I do not need humidifier to work. Removing humidifier does not look nice (need to store is somewhere, side of the cpap has no "rotating" tube ..) so attm I pushed some demineralized water in da humidifier and let air go over it (no water is spent during night) but the question here is, is it better to have humidifier completely empty when no humidification is required? When winter comes I will need humidifier to work (humidity in my room goes down to under 15% !!) but attm what's the best way to go about it.

2a. I have some "Citrus II CPAP Mask Cleaner", how the hack should I use this? Should I first clean mask and hose in warm water with some baby soap and then spray this cleaner and then rinse, or should I skip the water and soap and only spray with cleaner and then rinse or spray then soap then rinse or ... /me confused (It's a spray, smell's like lemon, on the spray they say you have to rinse after cleaning with spray, no details - I didn't get the "packaging", long story).

3. assuming my lungs are ok, is there any "issue" that can be caused with too high pressure (other then poor sleep), for e.g. now the setting is 4-13 (still waiting on the doc to schedule me appt so I can get real prescription so experimenting now myself) but it's not prescribed, it's me experimenting, I do not want to experiment if I can fsck something up

4. I assume vent on the mask is there so that when you exhale the co2 rich air is blown out with and oxygenated with fresh air from cpap so when you inhale you inhale fresh air.. from this I assume that length of the air hose is irrelevant. Is this assumption correct? Can I join 2 long hoses and make one super long?

5. oxygenation with external o2, I'm sure I'm not the first one to think of this but if part of our problem is low oxygen level in blood, if we breathe air that is richer with oxygen wouldn't that significantly improve our sleep? IIRC our brain wakes us up because our oxygen saturation in blood is low, not because we snore or because we stop breathing for any reason... if we add oxygen into air that would allow blood to stay oxygenated even with shallow interrupted breathing? Any study done on that? Any of the market oxygenator? Any down side of this? I heard too high oxygen level will speed up aging of the body but what's too high? Adding some o2 into the hose sounds like easy and safe thing to do but being noob I probably miss something obvious

6. On/Off switch - what's the deal with on-off switch missing from respironic !?!?! What's the reason for machine being 24/7 on when is used only 8 hours a day? Is there a reason for that? I can easily turn it on/off on the extension cord so for me is not a problem but should I? Is there a reason it works 24/7 or it's just some brilliant designer decided a power switch will make machine ugly?

that's all from me so far

[robysue]

Welcome to the forum.

1. date/time: when I load data into sleepyhead/encore I see data is properly timed (didn't really check if DST is properly handled but .. night is night, day is day..) but on my machine I do not see, anywhere, not even in the "secret setup" section, a way to edit date/time ?! I'm sure machine has to have a real time clock in order to work, and we all know they can drift from real time so having accurate time there is IMO required... anyone with idea how to read/set datetime on the PR machine? I'm expecting my oxymeter to arrive soon and I'm building one myself in the meantime, so pairing the two graphs would be meaningless if the two device do not have same datetime.

Unfortunately there is NO WAY to change the time setting on a PR machine even in the Clinical menu. The machine's time is supposed to be set to GMT at the factory. The software (both SleepyHead and Encore) take the GMT timestamps and translate to local time. Experimentation will likely show that the time on your PR is slightly off. My is set about 15 minutes too fast (i.e. it says it's 10:15 when it's only 10:00.) Totally a pain in the rear end when you are trying to synchronize data and a really BIG omission on PR's part

2. hygiene/humidifier, I read number of posts about "if you wanna clean your gear 2 times a day go do it, if you don't wanna clean it ever, don't..." with "no proven serious sickness induced by the cpap being dirty" ... anyhow, I'm interested in another thing.. I have humidifier attached to the cpap, it's summer now and humidity is very high so I do not need humidifier to work. Removing humidifier does not look nice (need to store is somewhere, side of the cpap has no "rotating" tube ..) so attm I pushed some demineralized water in da humidifier and let air go over it (no water is spent during night) but the question here is, is it better to have humidifier completely empty when no humidification is required? When winter comes I will need humidifier to work (humidity in my room goes down to under 15% !!) but attm what's the best way to go about it.

There should be no problem running the machine with the humidifier tank in place but with no water in the tank----as long as you don't turn the humidifier on. But putting some water in the tank and letting the air go over it with the humidifier turned off is also ok. It's called "passover mode" meaning the air passes over the (unheated) water. One advantage of using passover mode is that if you accidentally turn the humidifier on, you won't get a hot, empty humidifier tank which can stink. If you choose to use passover mode, just remember to change the water every 2-3 days. Also you don't need to fill the tank all the way to full if you use passover mode.

3. assuming my lungs are ok, is there any "issue" that can be caused with too high pressure (other then poor sleep), for e.g. now the setting is 4-13 (still waiting on the doc to schedule me appt so I can get real prescription so experimenting now myself) but it's not prescribed, it's me experimenting, I do not want to experiment if I can fsck something up

Before starting to experiment, what does your data look like in SleepyHead? Is your pressure sitting at 13 for long periods of time?? Are you having clusters of events with the pressure at 13??

4. I assume vent on the mask is there so that when you exhale the co2 rich air is blown out with and oxygenated with fresh air from cpap so when you inhale you inhale fresh air.. from this I assume that length of the air hose is irrelevant. Is this assumption correct? Can I join 2 long hoses and make one super long?

Yes, the vent on the mask is there to flush the CO2 out so that you don't rebreath it. As for joining 2 long hoses together: Hoses longer than the standard 6 foot length are available and it is possible to also join two 6 foot hoses together. But the machine's hose setting may need to be changed and the longer the hose, the more difficult it may be for the machine to properly detect breathing patterns and to properly maintain pressure. You need to get a copy of the clinical manual and read about how to attach longer than normal hoses.

5. oxygenation with external o2, I'm sure I'm not the first one to think of this but if part of our problem is low oxygen level in blood, if we breathe air that is richer with oxygen wouldn't that significantly improve our sleep? IIRC our brain wakes us up because our oxygen saturation in blood is low, not because we snore or because we stop breathing for any reason... if we add oxygen into air that would allow blood to stay oxygenated even with shallow interrupted breathing? Any study done on that? Any of the market oxygenator? Any down side of this? I heard too high oxygen level will speed up aging of the body but what's too high? Adding some o2 into the hose sounds like easy and safe thing to do but being noob I probably miss something obvious

If our lungs are healthy, the O2 desats occur because too little air is getting into our lungs during a hypopnea and NO air is getting into our lungs during an apnea. Once the PAP machine is properly preventing hypopneas and apneas from occuring, enough air is getting into our lungs for the proper O2/CO2 exchange to occur and the O2 desats no longer occur. Hence there's no need for added oxygen for CPAPer with healthy lungs.

Now if the lungs themselves have other issues that lead to O2 desaturation (such as COPD), the additional O2 may be needed to treat the non-OSA lung condition. Many CPAP masks have ports that allow them to be used with standard O2 tank tubing so that a person who has both OSA and COPD can get the O2 they need to treat the COPD and keep their airway open enough for that additional O2 to actually get into the lungs.

NOTE: If a person who has both COPD and OSA only uses the O2, the additional O2 cannot get into the lungs whenever the airway is physically blocked by an obstructive apnea. That's why a person with both conditions needs both the PAP and the supplemental O2.

In the US, O2 is only available through a prescription and the cost of the medical equipment for delivering the O2 is a month-to-month rental. The overall lifetime costs of O2 therapy may wind up being much higher than the lifetime costs for PAP therapy. And the O2 equipment may be much more difficult to travel with.

6. On/Off switch - what's the deal with on-off switch missing from respironic !?!?! What's the reason for machine being 24/7 on when is used only 8 hours a day? Is there a reason for that? I can easily turn it on/off on the extension cord so for me is not a problem but should I? Is there a reason it works 24/7 or it's just some brilliant designer decided a power switch will make machine ugly?

Like most digital equipment, when the machine is off (i.e. not delivering therapy), it is in standby mode and hence the display is still active. And yes standby mode does consume some electricity. There is no harm in unplugging the machine to turn it completely off.

[Pugsy]

I'm sure machine has to have a real time clock in order to work, and we all know they can drift from real time so having accurate time there is IMO required... anyone with idea how to read/set datetime on the PR machine?

The Respironics machines have an internal clock powered by an internal battery and the time is set to GMT time. Nothing we can do at the machine level to see the time or alter the time on the machine...so quit looking there.
If your time is off by a few minutes because sometimes the internal battery lets it happen there is nothing that can be done at the machine level but you can alter it in SleepyHead (can't in Encore Basic). In SleepyHead go to Preferences (under File) then the CPAP tab and look on the right side up at the very top in small letters is "clock drift"..you can adjust the reported times with this feature.
That way you can match up your pulse ox data when you get the oximeter.

Regarding humidifier....you can turn it off (set to 0) if you wish and either put some water in the tank or let it be totally dry but still attached so you can make use of the swivel feature for the hose. It's really up to you.
Setting to 0 with water allows for what we call passover humidity...minimal moisture gets picked up when the air is moving over the water.
Or you can just leave the tank dry and as long as the humidifier is set to 0 so that there is no heat...it hurts nothing to be sitting there empty. Make sure it is set to 0 though...those tanks sure smell bad when they get heated up without any water in them...been there and done that when I have forgotten to add water at the beginning of the night.
So it's really up to you how you wish to handle it. Again as you have already discovered...no hard fast rules.

The Citrus cpap cleaner..that's a sort of disinfectant too. If I used it I would use it first and then do my cleaning routine. It's more for germ killing but to be honest...hot soapy water does a good job too at killing germs.
Depending on the mask used, the Citrus cleaner may not do as good of a job as soapy water will when removing accumulated facial oils from the mask cushions.
So using it sort of depends on your germ phobia.. I don't have one so never bought anything special to disinfect my equipment.

Regarding potential problems with using too much pressure assuming no lung issues...
only potential problem would be maybe causing a substantial increase in central apneas (Clear airway even on your machine) and that risk is not nearly as high as people think it is. I often see pressures pushing 20 cm on my machine and I never have any more centrals than normal (it's normal to have a few). The thing is....it doesn't have to be a "high" pressure to cause centrals...it can happen even at 5 cm.
Now sometimes the changing pressures themselves can disrupt sleep and would of course be unwanted but that's more of an annoyance than a danger.

You can join two hoses but I wouldn't do it...at over 12 feet there might be an impact on therapy effectiveness...
They do make 10 ft hoses though...I think up to 10 foot that the machines won't be substantially affected by length of hose.
Over that...and I am not so sure and when in doubt I choose caution.
Of course the heated hose only comes in one size and you can't join them...

Oxygen level in air...okay if we increased the level of oxygen in air but the airway is closed and no air moves...it doesn't matter how rich in oxygen it is because there is no exchange. If adding oxygen to our air was all it took to keep blood levels up...we wouldn't be on these machines would we.
I will let someone else comment further on your oxygen questions.

Regarding the power thing....just because it has power to it doesn't mean it is totally on 24/7. It sort of goes into sleep mode I suppose.
There is no need to power down daily but it hurts nothing to unplug things if that is what you want to do.
Perhaps someone with more electrical sense than me can comment further.
Been on cpap/apap/bipap machines now for 4 years. Always left them plugged in and in standby mode without issues.
I have never been one to want to repeatedly plug something in or unplug frequently...for me that equals increased risk for me to screw it up or break something. If I was going to want to power totally off frequently.....I would use one of those surge protector things where the power plug goes into the device and the device is turned off with a switch.

[JohnBFisher]

First, greetings! Good for you for hunting through the forum for answers. You'll find most folks are pretty helpful on the forum, especially if you try to do some research and learning on your own.

1. How the date is handled depends on the various units. Unfortunately with your unit, there is no real way to change the time. It's a fixed time that's set in the factory (to GMT). But its clock is not all that accurate. So, it will slip some .. and might be off by quite a bit. You might be able to us SleepyHead to adjust the offset to the correct local time. I'll let others answer that.

2. Okay, I've been using xPAP devices for almost 25 years at this point. As long as you are healthy, you do NOT need to go overboard with cleaning. I try to change the filters monthly. I use only distilled water in the humidifier. So, I don't get a mineral residue build up. And it's sterile. I clean the humidifier chamber maybe once every six months or so. Sometimes you will get a "smell" in your unit ... then it's time to clean it. I have VERY few problems, even cleaning it that infrequently.

I just use hot (but hand safe) soapy water to clean the humidifier chamber, hose and mask. Then run clean water through the hose, and use the same to rinse off the humidifier chamber and mask parts.

2a. See note above. I don't wash my mask all that often. But I do use the mask cleaner wipes to clear off oils and gunk - that's the official term .

3. Nope. You've got to have MUCH higher pressure than these units produce for it to cause problems. I have an ASV unit that regularly provides pressure in the 25cm H2O range. You are about one half of that. You won't have any problems.

4. Yup. The vent on the mask allows you to exhale and allows the unit to wash out the exhaled air. You can use a longer hose, though it might mess up some of the automatic calculations for detecting apneas. I would stick with 8' or less for the hose length. If the hose gets too long it may also have a decrease in pressure at the mask. Again, stay at 8' or less. Others might have tried it with no problem. If so, go with their experience, since I don't have direct experience with a longer hose.

5. Our low saturated O2 levels in the blood is just due to not breathing. Ever seen a child hold it's breath and "turn blue". Same idea. If you stop breathing (because of an obstruction), then no amount of EXTERNAL O2 will drive up your blood O2 level .. until you resume breathing. So, no need to add O2 to your air intake. Instead you need to keep a steady stream of air heading into your lungs .. but eliminating the obstruction .. which is the point of our xPAP devices.

PS. Do NOT mess with O2 and your xPAP device unless you really need it. Remember, O2 and an electrical device can be a REALLY BAD combination if you get it wrong. Just as a note, most masks do include an oxygen intake vent, in case you actually need oxygen with xPAP therapy.

6. There are several reasons for not having an On/Off switch. The "Auto ON" feature is one reason. That way, put on your mask and it instantly works. Plus it costs money to have both the On/Off switch and an Auto ON feature. Should it be there? I think so. But a lot of manufacturers create devices that draw power when not in use. So they are not the first and won't be the last.


Hope that helps.

[chunkyfrog]

Welcome to the forum from me as well.
You have already heard from some of our heavy hitters; It sounds like you are already doing the research--good for you!
Bonus: also note the links at the bottom of Robysue and Pugsy's posts for additional info (if needed)

[arhi]

Thank you all for the welcomes and for great answers

Unfortunately there is NO WAY to change the time setting on a PR machine even in the Clinical menu.

The Respironics machines have an internal clock powered by an internal battery and the time is set to GMT time. Nothing we can do at the machine level to see the time or alter the time on the machine...so quit looking there.

Unfortunately with your unit, there is no real way to change the time

Darn how retarded decision from Philips
I do electronics as a hobby for few decades and I know how unstable crystal's are, especially when RTC is run from a batter and el-cheapo 32768Hz fork . I am sure they are using some classic rtc chip and that's it's super easy to change this when machine is open (maybe there's a service port on the machine I didn't find yet) but that would void the guarantee.. who knows, maybe I still do it might learn something new in da process

It's better to have the humidifier empty if you're not using it because even though we (should) use distilled water inside, it eventually gets a bit grotty (you may even see a little pinkish residue or other signs) and then you would want to clean it before use... not always a fun easy job... I'm more familiar with citrus 'wipes', which are barely moist,

One advantage of using passover mode is that if you accidentally turn the humidifier on, you won't get a hot, empty humidifier tank which can stink.

those tanks sure smell bad when they get heated up without any water in them... The Citrus cpap cleaner..that's a sort of disinfectant too.

Sometimes you will get a "smell" in your unit ... then it's time to clean it. I have VERY few problems, even cleaning it that infrequently.

Ah, the heating part I didn't think of initially, I will keep some water in for "just in case" I go crazy and turn the knob, knowing me it can easily happen so swapping small amount of water in the tank should be easy task (since I kinda figured cleaning mask and hose on 3 days is also for now good frequency). As for the filters this is something I will have to think about bit differently as I recently switched appt and attm this one is very dusty (the move is not 100% finished, cleaning not nearly done...) so I need to add some pre-filter before 2 filters cpap machine has but that should not be a problem as my dad has bunch of filters he use for cyclon machine for recovering plastic in powdercoating machine so I can get few square meters of some fine filtering material I can add to the air inlet. As for the citrus cleaner spray, one of the sites I visited before I ordered machine was something about "what's wrong with cpap machines" and guy talked about awful plastic smell of a new machine and how that smell don't ever go away and how machine pushes air into your stomach and .. and ... none of problems he mentioned I experienced (neither the plastic smell nor the pushing air into stomach nor...) but I ordered the cleaner/deodoriser as pre-emptive measure ... anyhow have not used it yet The spray clearly states I need to rinse the mask after use so it's not intended to "Stay on" like I assume wipes are.

Before starting to experiment, what does your data look like in SleepyHead? Is your pressure sitting at 13 for long periods of time?? Are you having clusters of events with the pressure at 13??

I had to start experimenting to get the data , I'll attach some pictures of my limited experience ... btw when looking at the data note that I need minimum 1h to go to sleep, I often lay down for few hours before I start the sleep cycle, it's often bigger problem for me then the apnea as tired as I am I can't even start sleeping, I lye and think about "why I am not asleap yet" and often after 4-5 hours of that I just get up and give up on sleep for that day...

[ edit ]
Hm, I'm not allowed to post attachments so I pushed images to my own server:
archive (8pictures): http://elco.crsndoo.com/files/cpap/arhicpap.zip
one by one:
http://elco.crsndoo.com/files/cpap/Capture.PNG
http://elco.crsndoo.com/files/cpap/Capture1.PNG
http://elco.crsndoo.com/files/cpap/Capture3.PNG
http://elco.crsndoo.com/files/cpap/Capture4.PNG
http://elco.crsndoo.com/files/cpap/Capture5.PNG
http://elco.crsndoo.com/files/cpap/Capture6.PNG
http://elco.crsndoo.com/files/cpap/Capture7.PNG
[ /edit ]

only potential problem would be maybe causing a substantial increase in central apneas (Clear airway even on your machine) and that risk is not nearly as high as people think it is.

Nope. You've got to have MUCH higher pressure than these units produce for it to cause problems. I have an ASV unit that regularly provides pressure in the 25cm H2O range. You are about one half of that. You won't have any problems.

Great, so for now I'm safe .

The length of the hose is relatively irrelevant - i.e. 10' is the longest recommended that would still allow effective therapy...

Hoses longer than the standard 6 foot length are available and it is possible to also join two 6 foot hoses together. But the machine's hose setting may need to be changed and the longer the hose, the more difficult it may be for the machine to properly detect breathing patterns and to properly maintain pressure. You need to get a copy of the clinical manual and read about how to attach longer than normal hoses.

You can join two hoses but I wouldn't do it...at over 12 feet there might be an impact on therapy effectiveness...
They do make 10 ft hoses though...I think up to 10 foot that the machines won't be substantially affected by length of hose.

I would stick with 8' or less for the hose length. If the hose gets too long it may also have a decrease in pressure at the mask.

great answers, thanks a bunch. this was mostly theoretical question as I have 2 hoses (as when I ordered machine + mask I ordered also the hose cover and a hose, when it arrived I now have one white and one gray hose, so the other hose came either with machine or with mask or with cover )

Having 02 along with cpap sounds like a great idea, but in fact is not, and can be problematic. One shouldn't use 02 unless you need it

If our lungs are healthy, the O2 desats occur because too little air is getting into our lungs during a hypopnea and NO air is getting into our lungs during an apnea. Once the PAP machine is properly preventing hypopneas and apneas from occuring, enough air is getting into our lungs for the proper O2/CO2 exchange to occur and the O2 desats no longer occur. Hence there's no need for added oxygen for CPAPer with healthy lungs.

Our low saturated O2 levels in the blood is just due to not breathing. Ever seen a child hold it's breath and "turn blue". Same idea. If you stop breathing (because of an obstruction), then no amount of EXTERNAL O2 will drive up your blood O2 level .. until you resume breathing. So, no need to add O2 to your air intake. Instead you need to keep a steady stream of air heading into your lungs .. but eliminating the obstruction .. which is the point of our xPAP devices.

Clear

Like most digital equipment, when the machine is off (i.e. not delivering therapy), it is in standby mode and hence the display is still active. And yes standby mode does consume some electricity. There is no harm in unplugging the machine to turn it completely off.

Regarding the power thing....just because it has power to it doesn't mean it is totally on 24/7. It sort of goes into sleep mode I suppose.
There is no need to power down daily but it hurts nothing to unplug things if that is what you want to do.

There are several reasons for not having an On/Off switch. The "Auto ON" feature is one reason. That way, put on your mask and it instantly works. Plus it costs money to have both the On/Off switch and an Auto ON feature. Should it be there? I think so. But a lot of manufacturers create devices that draw power when not in use. So they are not the first and won't be the last.

I know many reasons why they don't put a switch there but as someone pretty experienced with electronics I can say that quality of that power supply compares to el-cheapo long john PRC made crappiest PSU's one can order . That PSU is dead in a year 100%, it already squeels so while the cpap is drawing only few mA in stand by (there's actually a very simple way to draw even less but that's another story) the psu itself being crappy draws way more, dries out the elco's and produces the nasty sound. I have bunch of devices near my bed and all of them are on the single extension cord with a power switch and usually when I go from the bedroom in the morning I switch everything off and when I come to bedroom at evening I turn everything on so by doing that the auto-on feature works ok even while machine was without power for 16 hours.... I was hoping machine actualy do something (was not measuring current draw, will later on) while in stand by, for e.g. recalculate some settings from previous data, decides on the strategy on how to overcome these and those events .. but looks like it's just a classic "I do not care" design decision like most of today's devices are made with

thanks again

[arhi]

Welcome to the forum from me as well.
You have already heard from some of our heavy hitters; It sounds like you are already doing the research--good for you!
Bonus: also note the links at the bottom of Robysue and Pugsy's posts for additional info (if needed)

Thanks ... well I think it's rude just to hit ppl with questions without at least going trough all the "topped" threads and doing search on topic you are trying to query ppl for .. so I try to do some research before I jump out with "what will happen if I grab 230VAC with my hands"

signatures .. yeah, very useful

[robysue]

Before starting to experiment, what does your data look like in SleepyHead? Is your pressure sitting at 13 for long periods of time?? Are you having clusters of events with the pressure at 13??

I had to start experimenting to get the data , I'll attach some pictures of my limited experience ... btw when looking at the data note that I need minimum 1h to go to sleep, I often lay down for few hours before I start the sleep cycle, it's often bigger problem for me then the apnea as tired as I am I can't even start sleeping, I lye and think about "why I am not asleap yet" and often after 4-5 hours of that I just get up and give up on sleep for that day...

I bid you a sad welcome to the CPAP&Insomnia club.

Some comments:

Number crunching data. If you know you've got a long latency to sleep or that you lie in bed for long periods of time not sleeping, you'll soon figure out that it's not too hard to tell from the wave form when you are most likely not sleeping at all. If the machine is scoring events during those periods, it's because wake breathing and sleep breathing are two very different beasts. Wake breathing patterns are much more irregular than normal sleep breathing patterns and they can fool the machine into scoring events that are simply not there. You learn to just mentally discount those events after awhile. And to get a decent estimate of AHI, you also "machine run time" with "crude estimate of sleep time."

Insomnia advice. For some people, lying in bed AWAKE with the CPAP on leads to major discomfort problems. (I'm one of them.) And the more uncomfortable you are, the harder it is to fall asleep. (I was reminded of this truism on Saturday night's titration test when the tech put me to bed at 11:00pm, a good 3 hours before my typical 2:00am bed time.) If you find yourself focusing on just how uncomfortable everything is, you would be better off getting out of bed for a short period of time, going into a different room to do something relaxing and melatonin-friendly (NO watching the TV or getting on the computer since the blue light plays havoc with the melatonin cycle.) And returning to bed only after you get sleepy.

More seriously, since you have a long standing problem with insomnia, you may want to start actively addressing it while you are trying to adjust to CPAP. It will help the adjustment to CPAP if you can shorten the amount of time you spend lying in bed and thinking about "why I am not asleep yet". Best tip that was ever given to me here about my own battles with insomnia was to get a book called "Sound Sleep, Sound Mind" by Dr. Barry Krakow. The book is basically a self-help book, but it's biggest strengths are long discussions about common habits that insomniacs share that actively feed their insomnia. But Krakow's approach to dealing with many of these insomnia-producing habits goes beyond the typical "Good sleep hygiene rules" and his focus is very much on how an insomniac can actively work on getting their body and mind to make the connection that "Time in Bed" = "Time to be asleep." The last part of the book is a lengthy, eye-opening look at the connections between sleep disordered breathing (including OSA) and insomnia.


Re: A real On/Off switch:

I have bunch of devices near my bed and all of them are on the single extension cord with a power switch and usually when I go from the bedroom in the morning I switch everything off and when I come to bedroom at evening I turn everything on so by doing that the auto-on feature works ok even while machine was without power for 16 hours.... I was hoping machine actualy do something (was not measuring current draw, will later on) while in stand by, for e.g. recalculate some settings from previous data, decides on the strategy on how to overcome these and those events .. but looks like it's just a classic "I do not care" design decision like most of today's devices are made with

So plug the PAP into the extension cord and turn it off with everything else.

As for what it might do on its own: Shortly after NOON GMT (according to that inaccessible clock chip), the machine does update its on-board statistics that you can get at on the machine's LCD. These include 7-day and 30-day moving averages for AHI, 90% pressure levels, and very, very minimal leak info. (If you're interested in how these averages are computed, I've got a post about it somewhere on my blog.) But if the machine is turned off at that time, then it will update those averages during the boot sequence when it is plugged back in.

But the machine doesn't do any sophisticated analysis of tonight's overall data to decide on strategies for dealing with the next night.

Rather the machine does very sophisticated analysis of the breathing pattern in real time---i.e. while you're breathing (or not) and it makes adjustments to the pressure in real time based on what it's seeing in the wave flow. In layman's terms: The machine has algorithms for detecting apneas, hypopneas, flow limitations, snoring, and periodic breathing from just the wave flow and another algorithm for determining whether an apnea is an OA or a CA. It also has algorithms for detecting leaks and recording the total leak. For moderate size leaks, it takes the leak into account in figuring out how to maintain pressure and how to interpret the wave flow. If the leak rate is too large (i.e. near or in "large leak territory"), it also attempts to "fix" the leak by gradually reducing the pressure level to see if the mask will reseat itself at the lower pressure. (Unintentional mask leaks increase as the pressure setting goes up; in other words it's easier to maintain the seal at 6-8cm of pressure than it is at 14-16 cm of presssure.)

[arhi]

I bid you a sad welcome to the CPAP&Insomnia club.

Thanks .. can't say I'm glad to be a part of the club, but at least I'm glad I found this forum

not too hard to tell from the wave form when you are most likely not sleeping at all

noticing this already reading data is getting easier as data grows... great thing is that sleepyhead is open so adding some features would be possible too...

Insomnia advice. For some people, lying in bed AWAKE with the CPAP on leads to major discomfort problems. (I'm one of them.)

for now the wearing mask is not too discomforting for me. lying in bad awake is on it's own making my mind go crazy but I didn't notice cpap affecting this in any way

NO watching the TV or getting on the computer since the blue light plays havoc with the melatonin cycle.

I need to remove 30kg so attm I try to exercise when I decide I can't sleep .. works way better then sitting in front of computer .. as for the TV I removed that monstrosity from my life some 11 years ago

More seriously, since you have a long standing problem with insomnia, you may want to start actively addressing it while you are trying to adjust to CPAP. It will help the adjustment to CPAP if you can shorten the amount of time you spend lying in bed and thinking about "why I am not asleep yet". Best tip that was ever given to me here about my own battles with insomnia was to get a book called "Sound Sleep, Sound Mind" by Dr. Barry Krakow. The book is basically a self-help book, but it's biggest strengths are long discussions about common habits that insomniacs share that actively feed their insomnia. But Krakow's approach to dealing with many of these insomnia-producing habits goes beyond the typical "Good sleep hygiene rules" and his focus is very much on how an insomniac can actively work on getting their body and mind to make the connection that "Time in Bed" = "Time to be asleep." The last part of the book is a lengthy, eye-opening look at the connections between sleep disordered breathing (including OSA) and insomnia.

I know where my insomnia comes from, my head is full of ideas, even since I was a small kid, and I can't stop thinking about stuff, new ideas how to improve this and that, how to solve this and that problem... on top of that my dayjob is, apart from being super stressful, demanding on the innovative solutions, so doing the "clear your mind" routine never worked for me... the meditation .. tried many forms with many experienced guides .. never managed to do it, I know the theory, but looks like I have some glitch in my head that disallows me to truly clear my mind.. 99.999% medical experts I discussed the problem with gave me same answer -> this or that type of pills, and I refused to follow that path.. after many years I found about apnea and in theory by managing apnea problem I will get rid of "tiredness" that will give me energy to do more physical exercise and in my experience (of 20 years on the wrestling mat, before I gain all this excess %$#^%#^) physical exercise is best solution to insomnia, when your body is really tired, not from lack of air and lot of mental work, but from good hard physical hardship, you fall as sleep easily. But for number of years having energy and will power to train was hard... let's see if this cpap thingy solves this I heard hard to believe stories in how ppl lives changed.. hopefully I'm on right path

So plug the PAP into the extension cord and turn it off with everything else.

that was the idea, just wanted to be sure it's ok for the machine

[robysue]

I bid you a sad welcome to the CPAP&Insomnia club.

Thanks .. can't say I'm glad to be a part of the club, but at least I'm glad I found this forum

At least you're not the honorary president and seemingly charter member of the club, like I am.

I know where my insomnia comes from, my head is full of ideas, even since I was a small kid, and I can't stop thinking about stuff, new ideas how to improve this and that, how to solve this and that problem... on top of that my dayjob is, apart from being super stressful, demanding on the innovative solutions, so doing the "clear your mind" routine never worked for me... the meditation .. tried many forms with many experienced guides .. never managed to do it, I know the theory, but looks like I have some glitch in my head that disallows me to truly clear my mind..

I'm quite familiar with this "problem" which, in reality is not really a problem when that's the way your brain is wired. But---I think Krakow's book would do you some good. It and some fairly hard CBT for Insomnia finally allowed me to learn how to shut off my brain, which talks to me all the time with new thoughts, new ideas, pleasant daydreams, and stupid stuff. Before CPAP I'd lie in bed and pleasantly go through all kinds of not being able to stop thinking, planning, daydreaming, and when there was nothing else to contemplate, thinking about the crack in the ceiling right above the bed ..... It never bothered me that it would take an hour or more to fall asleep because I never got tense, upset, or angry. And I felt fine in the daytime.

But the mask triggered a whole lot of discomfort, which in turn triggered both aerophagia and anger. And lying in bed for an hour thinking became lying in bed for an hour thinking about how much I hated the whole CPAP thing and how uncomfortable I was phyically and how tired I'd bee the next morning since my daytime functioning took a nose dive right after I started CPAP. Krakow's book did a lot to help me figure out what things I was doing that was making it so difficult to fall asleep at night. And what kind of things I could try that would help stop all the thinking. The nice thing about Krakow's book is that he doesn't have a "magic" formula that he claims will work for everybody. Rather, he identifies a whole slew of behavior patterns common to insomniacs and for each behavior pattern he offers a whole slew of ideas to try. Quite frankly, your middle-of-the-night exercising fits right in with one of his major suggestions: If you're not sleepy, get up and do something that you want to do because you enjoy doing it.

Out of curiosity: How do you decide when to go to bed for the night? And how sleepy are you when you first go to bed. And don't confuse feeling sleepy with feeling tired or exhausted.

99.999% medical experts I discussed the problem with gave me same answer -> this or that type of pills, and I refused to follow that path..

I too have rejected advice to take pills of one sort or another many times in these last three years.

after many years I found about apnea and in theory by managing apnea problem I will get rid of "tiredness" that will give me energy to do more physical exercise and in my experience (of 20 years on the wrestling mat, before I gain all this excess %$#^%#^) physical exercise is best solution to insomnia, when your body is really tired, not from lack of air and lot of mental work, but from good hard physical hardship, you fall as sleep easily. But for number of years having energy and will power to train was hard... let's see if this cpap thingy solves this I heard hard to believe stories in how ppl lives changed.. hopefully I'm on right path

This again makes it sound like you'd get a lot out of reading Krakow's book. He's a strong advocate of investigating sleep disordered breathing as a cause of chronic insomnia.

Here's hoping that you can continue to lie in bed with the mask on for as long as you need to without experiencing the discomfort that I had in my early days.

[BlackSpinner]

Here's hoping that you can continue to lie in bed with the mask on for as long as you need to without experiencing the discomfort that I had in my early days.

After I got over the first few weeks of "pass out when going to bed", i am now back to my usual lay there for an hour or two with the mask on. I seem to move in and out of light sleep - sometimes.
Until I came to this board I didn't realize that this was supposed to be a problem. It was always a pleasant time of daydreaming, planing and designing art works. Only just before I got my cap machine it was a time of anxiety - mostly I realize now due to apnea events waking me up with my heart pounding.

[arhi]

Quite frankly, your middle-of-the-night exercising fits right in with one of his major suggestions: If you're not sleepy, get up and do something that you want to do because you enjoy doing it.

will check out the book for sure, already told my brother to send it from chicago, just takes time for it to travel from usa to the middle of nowhere where I live

Out of curiosity: How do you decide when to go to bed for the night? And how sleepy are you when you first go to bed. And don't confuse feeling sleepy with feeling tired or exhausted.

good question. I go to bed when "I should", for e.g. I have important meeting at 6:00 I go to bed at 23:00 hoping to catch some zz, if I have a meeting at 15:00 then I'd go to bed 04:00 or 05:00... problem is I feel sleepy 24/7, tired and exhausted I feel or don't depending on the day but sleepy, that I feel 24/7, it's just that feeling sleepy don't mean I can start the sleep cycle

Here's hoping that you can continue to lie in bed with the mask on for as long as you need to without experiencing the discomfort that I had in my early days.